Obstetric Nursing Final
Exam Questions
Course Introduction
Obstetric Nursing focuses on the holistic care of women during pregnancy, childbirth, and the postpartum period, as well as the immediate care of the newborn. This course covers the assessment, planning, implementation, and evaluation of nursing interventions to promote maternal and infant health. Students will learn about the physiological and psychological changes in pregnancy, prenatal care, labor and delivery management, postnatal support, common obstetric complications, and newborn assessment. Emphasis is placed on family-centered care, patient education, professional communication, and evidence-based practices to ensure safe and effective care for mothers and infants.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 7th Edition Murray
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27 Chapters
812 Verified Questions
812 Flashcards
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Chapter 1: Maternity and Womens Health Care Today
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant patient regarding this option, the nurse should be aware that this type of care setting includes which advantages? (Select all that apply.)
A) Staffing by lay midwives
B) Equipped for obstetric emergencies
C) Less expensive than acute care hospitals
D) Safe, homelike births in a familiar setting
E) Access to follow-up care for 6 weeks postpartum
Answer: C, D, E
Q2) The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)
A) Teaching the patient about breast care
B) Assessment of a patient's lochia and perineal area
C) Assisting a patient to the bathroom for the first time after birth
D) Vital signs on a postpartum patient who delivered the night before
E) Assisting a postpartum patient to take a shower on the second postpartum day
Answer: D, E
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Chapter 2: Social, Ethical, and Legal Issues
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, -1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse's response, based on the ethical principle of nonmaleficence, is which of the following?
A) Tell the patient that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
B) Have the patient write down her request and then call the physician for an order to implement the amniotomy.
C) Instruct the patient that only a physician or certified midwife can perform this procedure.
D) Give the patient an enema to stimulate labor.
Answer: C
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Chapter 3: Reproductive Anatomy and Physiology
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19 Flashcards
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Sample Questions
Q1) Which hormonal effect is noted during the menstrual cycle?
A) Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion rise during the ovulatory phase.
B) A negative feedback mechanism is exhibited by the anterior pituitary gland and ovaries.
C) The posterior pituitary gland secretes LH.
D) Estrogen secretion enhances FSH secretion.
Answer: A
Q2) The school nurse is conducting health education classes for a group of adolescent girls. Select the actions of the estrogen hormone that the nurse should include in the lessons. (Select all that apply.)
A) Stimulates contractions during birth
B) Relaxes pelvic ligaments during pregnancy
C) Stimulates the endometrium before ovulation
D) Stimulates growth of uterus during pregnancy
E) Stimulates the let-down reflex during breastfeeding
Answer: B, C, D
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5
Chapter 4: Hereditary and Environmental Influences on Childbearing
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Sample Questions
Q1) Which question posed by the nurse will most likely promote the sharing of sensitive information during a genetic counseling interview?
A) "What kind of defects or diseases seem to run in the family?"
B) "How many people in your family are mentally retarded or handicapped?"
C) "Did you know that you can always have an abortion if the fetus is abnormal?"
D) "Are there any members of your family who have learning or developmental problems?"
Q2) Which characteristic is related to Down syndrome?
A) Up-slanting eyes
B) Abnormal genitalia
C) Bleeding tendency
D) Edema of extremities
Q3) Which statement regarding multifactorial disorders is correct?
A) They may not be evident until later in life.
B) They are usually present and detectable at birth.
C) The disorders are characterized by multiple defects.
D) Secondary defects are rarely associated with them.
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Page 6
Chapter 5: Conception and Prenatal Development
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Sample Questions
Q1) Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy, including which of the following? (Select all that apply.)
A) Insulin
B) Estrogen
C) Progesterone
D) Testosterone
E) Human chorionic gonadotropin (hCG)
Q2) The nurse is assessing a newborn immediately after birth. After assigning the first Apgar score of 9, the nurse notes two vessels in the umbilical cord. What is the nurse's next action?
A) Assess for other abnormalities of the infant.
B) Note the assessment finding in the infant's chart.
C) Notify the health care provider of the assessment finding.
D) Call for the neonatal resuscitation team to attend the infant immediately.
Q3) What is the purpose of the ovum's zona pellucida?
A) Prevents multiple sperm from fertilizing the ovum
B) Stimulates the ovum to begin mitotic cell division
C) Allows the 46 chromosomes from each gamete to merge
D) Makes a pathway for more than one sperm to reach the ovum
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Chapter 6: Maternal Adaptations to Pregnancy
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Sample Questions
Q1) A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. Which is the correct interpretation of these symptoms by the health care provider?
A) Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
B) These conditions are abnormal. Refer the patient to an ear, nose, and throat specialist.
C) Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits.
D) Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.
Q2) The capacity of the uterus in a term pregnancy is how many times its prepregnant capacity? Record your answer as a whole number. ______ times
Q3) Physiologic anemia often occurs during pregnancy due to
A) inadequate intake of iron.
B) the fetus establishing iron stores.
C) dilution of hemoglobin concentration.
D) decreased production of erythrocytes.
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Chapter 7: Antepartum Assessment, Care, and Education
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Sample Questions
Q1) Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?
A) Neuromuscular disassociation
B) Effleurage
C) Psychoprophylaxis
D) Sacral pressure
Q2) Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation.
A) G5 T1 P2 A2 L 2
B) G5 T1 P1 A1 L2
C) G5 T0 P2 A2 L2
D) G5 T1 P1 A2 L2
Q3) What does a birth plan help the parents accomplish?
A) Avoidance of an episiotomy
B) Determining the outcome of the birth
C) Assuming complete control of the situation
D) Taking an active part in planning the birth experience
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Chapter 8: Nutrition for Childbearing
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Sample Questions
Q1) For the pregnant patient who is a vegan, what combination of foods will the nurse advise to meet the nutritional needs for all essential amino acids?
A) Eggs and beans
B) Fruits and vegetables
C) Grains and legumes
D) Vitamin and mineral supplements
Q2) When planning a healthy diet with a pregnant patient, what should the nurse's first action be?
A) Teach the patient about MyPlate.
B) Review the patient's current dietary intake.
C) Instruct the patient to limit the intake of fatty foods.
D) Caution the patient to avoid large doses of vitamins, especially those that are fat-soluble.
Q3) A pregnant patient's diet may not meet her need for folate. Which food choice is an excellent source of this nutrient?
A) Chicken
B) Cheese
C) Potatoes
D) Green leafy vegetables
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Page 10
Chapter 9: Assessing the Fetus
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Sample Questions
Q1) What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per minute (BPM) with fetal movement in a 20-minute period?
A) Positive
B) Negative
C) Reactive
D) Nonreactive
Q2) In preparing a pregnant patient for a nonstress test (NST), which of the following should be included in the plan of care?
A) Have the patient void prior to being placed on the fetal monitor because a full bladder will interfere with results.
B) Maintain NPO status prior to testing.
C) Position the patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
D) Have an infusion pump prepared with oxytocin per protocol for evaluation.
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Chapter 10: Complications of Pregnancy
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Sample Questions
Q1) The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
A) Female fetus, Mexican-American, primigravida
B) Male fetus, Asian-American, previous preterm birth
C) Male fetus, African-American, previous cesarean birth
D) Female fetus, European-American, previous spontaneous abortion
Q2) Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?
A) Hypoglycemia
B) Hypercalcemia
C) Hypoinsulinemia
D) Hypobilirubinemia
Q3) Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
A) Blood pressure of 120/80 mm Hg
B) Complaint of frequent mild nausea
C) Fundal height measurement of 18 cm
D) History of bright red spotting for 1 day weeks ago
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Page 12
Chapter 11: The Childbearing Family with Special Needs
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Sample Questions
Q1) A patient who is older than 35 years may have difficulty achieving pregnancy because
A) prepregnancy medical attention is lacking.
B) personal risk behaviors influence fertility.
C) contraceptives have been used for an extended period of time.
D) the ovaries may be affected by the normal aging process.
Q2) Which congenital defects in a newborn are associated with long-term parenting problems? (Select all that apply.)
A) Polydactyl
B) Cleft lip and palate
C) Ventral septal defect
D) Ambiguous genitalia
Q3) Which action should the nurse take when counseling a teenaged patient who has decided to relinquish her baby for adoption?
A) Question her about her feelings regarding adoption.
B) Tell her she can always change her mind about adoption.
C) Affirm her decision while acknowledging her maturity in making it.
D) Ask her if anyone is coercing her into the decision to relinquish her baby.
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Chapter 12: Processes of Birth
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Sample Questions
Q1) Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
A) Extension
B) Engagement
C) Internal rotation
D) External rotation
Q2) A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
A) Latent phase
B) Active phase
C) Second stage
D) Third stage
Q3) On admission to the labor and birth unit, a 38-year-old female, gravida 4, para 3, at term in early labor is found to have a transverse lie on vaginal examination. What is the priority intervention at this time?
A) Perform a vaginal exam to denote progress.
B) Notify the health care provider.
C) Initiate parenteral therapy.
D) Apply oxygen via nasal cannula at 8 L/minute.
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14
Chapter 13: Pain Management During Childbirth
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39 Flashcards
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Sample Questions
Q1) Which method of pain management would be safest for a gravida 3, para 2, admitted at 8 cm cervical dilation?
A) Narcotics
B) Spinal block
C) Epidural anesthesia
D) Breathing and relaxation techniques
Q2) Which fetal position may cause the laboring patient increased back discomfort?
A) Left occiput anterior
B) Left occiput posterior
C) Right occiput anterior
D) Right occiput transverse
Q3) A patient in labor reports a feeling of burning pain during the second stage of labor. This type of pain is associated with
A) visceral pain.
B) tissue ischemia.
C) somatic pain.
D) cervical dilation.
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Chapter 14: Intrapartum Fetal Surveillance
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Sample Questions
Q1) When a Category II pattern of the fetal heart rate is noted and the patient is lying on her left side, which nursing action is indicated?
A) Lower the head of the bed.
B) Place a wedge under the left hip.
C) Change her position to the right side.
D) Place the mother in Trendelenburg position.
Q2) Observation of a fetal heart rate pattern indicates an increase in heart rate from the prior baseline rate of 152 bpm. Which physiologic mechanisms would account for this situation?
A) Inhibition of epinephrine
B) Inhibition of norepinephrine
C) Stimulation of the vagus nerve
D) Sympathetic stimulation
Q3) Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
A) Unruptured membranes
B) Cervix dilated to 4 cm
C) Fetus has known heart defect
D) Maternal HIV
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Page 16
Chapter 15: Nursing Care During Labor and Birth
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Sample Questions
Q1) Which comfort measure should the nurse utilize in order to enable a laboring woman to relax?
A) Recommend frequent position changes.
B) Palpate her filling bladder every 15 minutes.
C) Offer warm wet cloths to use on the patient's face and neck.
D) Keep the room lights lit so the patient and her coach can see everything.
Q2) Which nursing assessment indicates that a patient who is in the second stage of labor is almost ready to give birth?
A) Bloody mucous discharge increases.
B) The vulva bulges and encircles the fetal head.
C) The membranes rupture during a contraction.
D) The fetal head is felt at 0 station during the vaginal examination.
Q3) Which interventions should be performed in the birth room to facilitate thermoregulation of the newborn? (Select all that apply.)
A) Place the infant covered with blankets in the radiant warmer.
B) Dry the infant off with sterile towels.
C) Place stockinette cap on infant's head.
D) Bathe the newborn within 30 minutes of birth.
E) Remove wet linen as needed.
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Page 17
Chapter 16: Intrapartum Complications
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Sample Questions
Q1) An obstetric patient has been identified as being high risk. The patient has had activities restricted (placed on bed rest) until the end of the pregnancy. Currently, she is at 32 weeks' gestation and has two other children at home, ages 3 and 6. The patient's husband works at home. A nursing diagnosis of Impaired Home Maintenance is noted. Which statement potentially identifies a long-term goal?
A) The patient and husband will be able to adapt their schedules accordingly to meet activities of daily living until the patient's next scheduled antepartum visit the following week.
B) The patient and husband will hire a nanny to act as an additional caregiver for the next month.
C) The patient will continue to take care of her children at home, taking frequent rest periods.
D) The patient and husband will make arrangements for child care routine activity assistance for the rest of the pregnancy.
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Chapter 17: Postpartum Adaptations and Nursing Care
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Sample Questions
Q1) The nurse is teaching a non-breastfeeding patient measure to suppress lactation. Which information should the nurse include in the teaching session? (Select all that apply.)
A) Avoid massaging the breasts.
B) Allow warm shower water to run over the breasts.
C) If the breasts become engorged, pumping is recommended.
D) Ice packs or cabbage leaves can be applied to the breasts to relieve discomfort.
E) Wear a sports bra 24 hours a day until the breasts become soft.
Q2) Which should the nurse do to provide support to a patient who must return to full-time employment 6 weeks after a vaginal birth?
A) Discuss child care arrangements with her.
B) Allow her to solve the problem on her own.
C) Reassure her that she'll get used to leaving her baby.
D) Allow her to express her positive and negative feelings freely.
Q3) When assessing the A of the acronym REEDA, the nurse should evaluate the A) skin color.
B) degree of edema.
C) edges of the episiotomy.
D) episiotomy for discharge.
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Page 19
Chapter 18: Postpartum Maternal Complications
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Sample Questions
Q1) The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the midline, and 2 cm above the umbilicus. What is the nurse's priority action?
A) Massage the fundus of the uterus.
B) Assist the patient out of bed to void.
C) Increase the infusion of oxytocin (Pitocin).
D) Ask another nurse to bring in a straight catheter tray.
Q2) If the nurse suspects a complication of a low forceps birth labor, she should immediately
A) administer a strong oral analgesic.
B) assess the perineal and vaginal areas.
C) assess the position of the uterine fundus.
D) review the labor record for duration of second stage.
Q3) Which measure may prevent mastitis in a breastfeeding patient?
A) Wearing a tight-fitting bra.
B) Applying ice packs prior to feeding.
C) Initiating early and frequent feedings.
D) Nursing the infant for 5 minutes on each breast.
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Page 20
Chapter 19: Normal Newborn: Processes of Adaptation
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Sample Questions
Q1) Which newborn is at higher risk for developing hypoglycemia? (Select all that apply.)
A) Post-term newborn
B) 38 weeks' gestation newborn
C) Small-for-gestational-age newborn
D) Large-for-gestational-age newborn
E) Term newborn delivered by cesarean birth
Q2) In the newborn nursery, you are reviewing the maternal medication list to ascertain if there is any significant risk to the newborn. Which medications would pose a potential risk to the newborn in terms of clotting ability? (Select all that apply.)
A) Carbamazepine
B) Phenytoin (Dilantin)
C) Phenobarbital
D) INH (Isoniazid)
E) Prenatal vitamins with iron
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Chapter 20: Assessment of the Normal Newborn
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Sample Questions
Q1) Infants who develop cephalohematoma are at an increased risk for A) infection.
B) jaundice.
C) caput succedaneum.
D) erythema toxicum.
Q2) The nurse is assessing a newborn delivered 24 hours ago for jaundice. What is the best way to evaluate for this finding?
A) Depress the tip of the nose.
B) Stroke the outer aspect of the foot.
C) Place a finger in the palm of the hand.
D) Rotate the hips in an upward and outward direction.
Q3) A newborn that is a large-for-gestational-age (LGA) infant is in which percentile(s) for weight?
A) Below the 90th
B) Less than the 10th
C) Greater than the 90th
D) Between the 10th and 90th
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22
Chapter 21: Care of the Normal Newborn
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Sample Questions
Q1) The nurse is preparing a newborn for a circumcision. Which prescribed interventions should the nurse implement to alleviate pain? (Select all that apply.)
A) Oral sucrose during the procedure
B) Bright lights after the procedure
C) Adequate stimulation before and after the procedure
D) Acetaminophen (Tylenol) postprocedure, as needed
E) EMLA cream (eutectic mixture of local anesthetics) before the procedure
Q2) When an infant's temperature drops from (37 to 36.3°C) 98.7 to 97.4°F, the nurse should
A) instruct parents on the risks of cold stress.
B) determine the time and amount of last feeding.
C) increase the temperature in the mother's room.
D) evaluate infant for the presence of a blood sugar level higher than 50 mg/dL.
Q3) An infant who eats very rapidly may experience problems with swallowing excessive air. What should the mother be instructed to do?
A) Use a nipple with a smaller hole.
B) Place the infant on the abdomen after feeding.
C) Provide the infant with water between feedings.
D) Begin the feeding before the infant becomes too hungry.
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Page 23
Chapter 22: Infant Feeding
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Sample Questions
Q1) Which woman is most likely to continue breastfeeding beyond 6 months?
A) A woman who avoids using bottles.
B) A woman who uses formula for every other feeding.
C) A woman who offers water or formula after breastfeeding.
D) A woman whose infant is satisfied for 4 hours after the feeding.
Q2) For which infant should the nurse anticipate the use of soy formula? (Select all that apply.)
A) Preterm infant
B) Infant with galactosemia
C) Infant with phenylketonuria
D) Infant with lactase deficiency
E) Infant with a malabsorption disorder
Q3) What is the most serious consequence of propping an infant's bottle?
A) Colic
B) Aspiration
C) Dental caries
D) Ear infections
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24
Chapter 23: High-Risk Newborn: Complications Associated with Gestational Age and Development
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Sample Questions
Q1) A preterm infant is on a ventilator, with intravenous lines and other medical equipment. When the parents come to visit for the first time, what is the most important action by the nurse?
A) Encourage the parents to touch their infant.
B) Reassure the parents that the infant is progressing well.
C) Discuss the care they will give their infant when the infant goes home.
D) Suggest that the parents visit for only a short time to reduce their anxiety.
Q2) An infant presents with lethargy in the newborn nursery on the second day of life. On further examination, vital signs are stable and muscle tone is slightly decreased, with sluggish reflexes noted. Other physical characteristics are noted as being normal. Lab tests reveal a decreased hematocrit and increased blood sugar. The nurse suspects that the infant may be exhibiting signs and symptoms of A) RDS.
B) PIVH.
C) BPD.
D) ROP.
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25
Chapter 24: High-Risk Newborn: Acquired and Congenital Conditions
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Sample Questions
Q1) Transitory tachypnea of the newborn (TTN) is thought to occur as a result of A) a lack of surfactant.
B) hypoinflation of the lungs.
C) inadequate absorption of fetal lung fluid.
D) a delayed vaginal birth associated with meconium-stained fluid.
Q2) Which intervention will increase the effectiveness in reducing the indirect bilirubin in an affected newborn?
A) Turn the infant every 2 hours.
B) Place eye patches on the newborn.
C) Wrap the infant in triple blankets to prevent cold stress.
D) Increase the oral intake of water between and before feedings.
Q3) Infection can be transmitted to the neonate from mother during the pregnancy or birth or from the mother, family members, visitors, or agency staff after birth. Which viral infections are most likely to be transmitted during the birth process? (Select all that apply.)
A) Hepatitis B
B) Rubella
C) Herpes
D) Varicella Zoster
E) Cytomegalovirus
Page 26
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Chapter 25: Family Planning
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Sample Questions
Q1) The role of the nurse in family planning is to
A) refer the couple to a reliable physician.
B) decide on the best method for the couple.
C) advise couples on which contraceptive to use.
D) educate couples on the various methods of contraception.
Q2) Which symptom in a patient using oral contraceptives should be reported to the physician immediately?
A) 5-lb weight gain
B) Leg pain and edema
C) Decrease in menstrual flow
D) Increased pigmentation of the face
Q3) The major difference between the diaphragm and the cervical cap is that the diaphragm
A) is more effective.
B) requires spermicide.
C) applies pressure on the urethra.
D) has no contribution to toxic shock syndrome.
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Chapter 26: Infertility
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Sample Questions
Q1) Which factors would contribute to abnormalities of the fallopian tube associated with the development of infertility? (Select all that apply.)
A) History of conization of the cervix
B) History of pelvic surgical procedures
C) Incompetent cervix
D) Past treatments of STD with follow-up test of cure
E) Endometriosis
Q2) A woman undergoing evaluation of infertility states, "At least when we're through with all of these tests, we will know what is wrong." The nurse's best response is
A) "I know the test will identify what is wrong."
B) "I'm sure that once you finish these tests, your problem will be resolved."
C) "Even with diagnostic testing, infertility remains unexplained in about 20% of couples."
D) "Once you've identified your problem, you may want to look at the option of adoption."
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Chapter 27: Womens Health
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Sample Questions
Q1) You are taking care of a patient who has had a colporrhaphy. Which option would indicate a priority assessment during the postoperative period?
A) Documentation of a pessary in the operative procedure notes by the physician
B) Removal of vaginal packing as ordered by the physician
C) Use of a cell saver for transfusion therapy in the postoperative period
D) Order for removal of staples 2 to 3 days post-procedure
Q2) Which patient is most likely to develop osteoporosis?
A) A 50-year-old patient on estrogen therapy
B) A 55-year-old patient with a sedentary lifestyle
C) A 65-year-old patient who walks 2 miles each day
D) A 60-year-old patient who takes supplemental calcium
Q3) Which specific instruction should the nurse teach to assist a patient to regain control of her urinary sphincter?
A) Perform Kegel exercises.
B) Void every hour while awake.
C) Drink 8 to 10 glasses of water each day.
D) Allow the bladder to become distended before voiding.
To view all questions and flashcards with answers, click on the resource link above.
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